Eligibility Consultant (Meritain Health)

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryAs an Eligibility Consultant, you will:

• Verify other insurance information from a variety of communication returned by members and groups, consult with coordination rules, and make changes to member/client records within the expected TAT (Turn Around Time).


• Maintain member’s other insurance record using a variety of incoming information. Identify and address any concerns from missing or incorrect information already in the record.


• Utilize and interpret online resources to understand account structure and coordination rules.


• Respond, research, and resolve coordination related issues involving member specific information by working directly with internal partners to achieve positive service outcomes.


• Work with internal partners to obtain missing information within group’s set communication parameters.


• Receive communication from other departments, including customer service, to maintain member’s record concerning other insurance information and certain demographic details.


• Ensure all communications with clients, third-party administrators, and/or brokers involving sensitive member data adhere to HIPAA (Health Insurance Portability and Accountability Act) compliance requirements.


• Maintain a record of returned mail for individual member records.


• Communicate directly with brokers and groups to obtain updated addresses when returned mail is identified.


• Facilitate the re-mailing of some communications when updated address information can be obtained.

Required Qualifications

• At least 1 year of data entry experience.


• Working knowledge of Microsoft Office products (Word, Excel, PowerPoint, Outlook).


• Must reside either in East Lansing, MI or Arizona.


• If residing in East Lansing, MI, must have the ability to work a hybrid schedule (3 days in office per week).

Preferred Qualifications

• Previous experience in healthcare data entry.


• Knowledge of and/or experience with eligibility or coordination of benefits (COBs).


• Strong written and verbal communication skills, including active listening, professional phone etiquette, and attention to spelling, grammar, and proof reading.


• Organized and dependable, with a focus on producing accurate and timely results.


• Comfortable with data entry and working in various systems with accuracy and attention to detail.


• Ability to manage high volumes of work and handle a variety of incoming tasks with shifting priorities.


• Takes initiative and works independently, demonstrating an understanding of task intent and goals with minimal guidance.


• Strong problem-solving skills, with the ability to identify improvements and think creatively.


• Effective follow-up skills to ensure timely resolution of issues.


• Collaborative team player who contributes to a supportive team environment.

Education

• High school diploma or GED.

Anticipated Weekly Hours 40Time Type Full timePay RangeThe typical pay range for this role is:$17.00 - $31.30This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.For more information, visitWe anticipate the application window for this opening will close on: 06/13/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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